Heart failure & cardiomyopathiesRandomised controlled trial
Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial
- Randomised controlled trial
- double-blind
- cross-over
Authors' conclusion
KE treatment for 14 days was associated with higher CO at rest and lower filling pressures, cardiac volumes, and NT-proBNP levels compared with isocaloric comparator.
Study context
- Population
- Nondiabetic patients with HFrEFcross-over, 14-day washout
- Participants
- 24 patients
- Comparison
- Ketone ester (KE) vs isocaloric non-KE comparator
- Primary endpoint
- Resting cardiac output (CO)
- Follow-up
- After each 14-day treatment period
Primary result
Resting CO at trough levels
Difference
0.3 L/min
95% CI 0.1–0.5
By group
KE vs Isocaloric comparator
difference 0.3 L/min (95% CI 0.1–0.5)
As reported in the abstract
Secondary outcomes
mm Hg
| Outcome | KE | Isocaloric comparator | difference (mm Hg) (95% CI) | P value | |
|---|---|---|---|---|---|
| Resting PCWP at trough levels | 8 (SD 3) | 11 (SD 3) | −2 (−4 to −1) | ||
| Mean exercise PCWP and CO across all exercise intensities · exercise PCWP | −3 (−5 to −1) | ||||
| −6−4−202Difference, mm Hg (linear scale) |
| Outcome | difference (L/min) (95% CI) | P value | |
|---|---|---|---|
| Mean exercise PCWP and CO across all exercise intensities · CO | 0.5 (0.1–0.8) | ||
| −0.500.51Difference, L/min (linear scale) |
| Outcome | difference (ng/L) (95% CI) | P value | |
|---|---|---|---|
| NT-proBNP (exploratory) · 18% lower · exploratory analysis | −98 (−185 to −23) | ||
| −200−1000100Difference, ng/L (linear scale) |
LVEF (exploratory) · exploratory analysis
P = 0.01
Mean exercise PCWP and cardiac output (CO) across all exercise intensities
- Significant at low to moderate steady-state exercise but not at peak
Metabolic equivalents
- Similar between treatments
LVEF (exploratory)
- Lower left atrial and ventricular volumes with KE
Original publication
Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial. Circulation. Published 27 March 2024. doi:10.1161/circulationaha.123.067971
Summarised from the published abstract; every number is checked against it